03 May 2009

The geographic concentration of the uninsured seems a bit ironic, given that the South and Southwest are not known for being Democratic strongholds agitating for a universal-coverage-single-payer system. But most of the uninsured fall heavily among the ranks of non-voters. The Republican congressional delegations from these states have little political incentive to work on this issue with President Obama. But the President doesn’t look like he needs them, either.

Good point.

The thing that I find striking is how otherwise demographically different states can dramatically differ in their uninsured rates. Look at Iowa and Nebraska, or Minnesota and the Dakotas. Clearly there's some key difference in the laws and regulations of those states which makes it easier to be uninsured there. For that matter, Alabama and Mississippi are quite different as well, despite being comparable in other ways.

And what's up with Florida? For a relatively affluent state, it's almost as bad as Texas, despite having a far smaller illegal immigrant population.

7 comments:

I'd bet a significant factor in that map is the migration patterns of Americans moving south and west for jobs in the last thirty years, jobs which have less and less often come with a lifetime of ancillary benefits like insurance. In the east and northeast, even those old retired millworkers whose jobs and factories are gone might be insured from their union.

(Standard Comment Section Disclaimer: The above is just a theory off the top of my head based on no research or actual knowledge.)

Republicans, "Dixie Democrats", a disproportionate amount of retirees who came here for the no-state-income-tax joy and resent being asked to pay, say, property tax because it mainly benefits schools and children and theirs are already grown.

The biggest employers in this state tend to be service industries or agriculture, neither of which are well-known for offering generous--or any--health benefit packages. In fact, my husband's nursery and farm stand almost alone in that he offers matching-fund health-care to employees. This is in addition to regular raises, Christmas bonuses, and paid holidays and even vacations, as they do in Italy and the rest of Europe. He reasons that it's a plus to have a loyal, well-trained staff he can trust and that he doesn't have to spend many hours a week personally training, as one would with new workers.

Service industries--restaurants, hotels, etc.--are notorious for not offering healthcare insurance benefits (or, for that matter, any benefits at all beyond the job itself). Some will say it's because of the high turnover and preponderance of part-time workers, as though people who work and go to school are less likely to need the doctor, or something? As for the majority of Ag businesses, unlike Robert's nurseries' workers, who are largely Mexican-American permanent residents and American citizens who live in town and who've been with us for a decade or more, they tend to be seasonal migrant workers who are paid shockingly low wages and are in the States on special visas. The large Ag companies who hire them sometimes (but not always) provide basic dorm-style housing, for which they collect weekly rent via deductions from the already-meager paychecks (and sometimes said housing is dismally inadequate, if not outright inhumane and safety-code-violating), but health insurance? HA!

We could also remove the link between health coverage and employment. The problem is Shadowfax is against it in spite of the fact that the McCain health reform plan was originally proposed by Jason Furman a current adviser to the President.

Nurse K, good grief--how are the workers to whom I referred illegal? Our employees are all US citizens (both naturalized and native-born) or else permanent resident aliens (like me).

And seasonal migrant workers at larger companies' farms come to the US legally too, on H-2A visas; there are about 30,000 such employees in the States right now. Legally. They are the men and women who pick, clean, and pack your fruit and vegetables for you.

Hey, guess what, litbrit, I was responding to the linked post and that map-thingy that the blog host wanted to discuss, not you...

If the legal Mexican workers, btw, aren't happy with their working conditions here in the US, they are more than welcome to do the same thing for less than a buck-an-hour in Mexico and still get no health care.

This post doesn't indicate if "uninsured" includes Medicaid, which is not insurance.

Shadowfax

About me: I am an ER physician and administrator living in the Pacific Northwest. I live with my wife and four kids. Various other interests include Shorin-ryu karate, general aviation, Irish music, Apple computers, and progressive politics. My kids do their best to ensure that I have little time to pursue these hobbies.

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